Stories about Work and Resistance

Health is about life, and health work makes business of our basic human functions. It should be no surprise then that health care is under attack globally where the decay of the neoliberal order has incited conflicts over who will control health resources. Over the next few months Recomposition will explore the health care perspectives and proposals for alternatives. We are proud to present the first installment in our Health Series with an interview that comes to us from members of the Health Sector Workers Network located in Aotearoa/New Zealand. They discuss attempting to build cross-workplace and cross-trade solidarity, the recent series of Junior Doctor’s strikes (the equivalent of residents in the US), and building workers resistance to health austerity.

1. Tell us a bit about yourself. What kind of work do you do, and how did you get involved in the health workers movement?

My name is Al. I’ve worked in the public health sector, off and on, for most of my adult life, both in New Zealand and Australia. I’ve worked in Public Hospitals as a Laundry Assistant, Cleaner, Orderly and currently as a Nurse Assistant/Hospital Aide.
In all this time I’ve been a member and often a workplace delegate of whichever Union has represented workers in each area.

A couple of things have always frustrated me when it came working in the health sector. They are the internal hierarchies and the divisions created by having so many different Unions organising workers in this sector. I see this as hugely divisive as we lose our collective strength when we organise separately.

At times management/bosses will use these division to play workers off against each other, as we have recently seen with the dispute between Ambulance Officers/Paramedics from FIRST Union and St John. There are also currently five separate Unions competing for members and not working cohesively or cooperatively.

I’ve been inspired by the methods of anarcho-syndicalism and especially the activities of the IWW, Solidarity Federations in the UK and Seattle Solidarity Network in the USA. It really was the ideas of the IWW which got me thinking about establishing the Health Sector Workers Network, with the possibilities of one day seeing the ‘one big union’ approach taken in the health sector.

Just to note… the following questions have been answered and edited by a few of the HSWN members, so express a collective view, rather than just mine.

2. In October thousands of Junior Doctors (the equivalent of doctors-in-training in the US) went on strike over working conditions and safety. What conditions led to this strike and what happened with it?

Recent Junior Doctor industrial action has taken place after failed Multi Employer Collective Agreement (MECA) negotiations between the Resident Doctors Association (RDA) and the District Health Boards (DHBs). In Aotearoa/New Zealand there are 20 DHBs – which are different health boards for different regions of the country. Each of these are ‘employers’ and the MECA is the collective agreement between all workers (i.e. doctors in this instance) across all of these health board employers. Negotiations began initially in January 2016. The primary issue in this round of contract negotiations has been working conditions and patient safety. The RDA is pushing for a contractual commitment to reducing the duration of consecutive working days from 12 to 10, a maximum of 10 days per fortnight, and a change from seven consecutive nights to a maximum of four. The DHBs have not agreed to these changes. To date RDA members have gone on strike for two days in October 2016 and and three days in January 2017. A further planned strike in November was aborted after the Kaikoura earthquake. The RDA / DHBs may be moving closer to resolution but as of 22 January 2017 this has not been achieved. It is notable that the, debatably, most dangerous roster practice of 15-16 hour days (often done back to back over weekends) is not been part of proposed changes in rooster practices. The reason for this is not clear.

3. Similar strikes have happened lately in Europe, do you seen any reason why now junior doctors are organizing?

Speaking for the NZ situation this is not the first time in recent history the RDA has undertaken industrial action in the context of failing MECA negotiations. For instance, there were strikes in 2008 when RDA demands for a salary increase (on a debatable rationale of increasing staff retention) were declined by the DHBs. However, on the face of it, the basis for 2016-17 action (working conditions-patient safety) is different. It is possible that Junior Doctors, as part of wider health system changes, are recognising and placing greater emphasis on patient safety and are feeling able to question the status quo more than they have done historically. Health funding in NZ has been declining for sometime and there can be parallels drawn between what is happening here with the UK, where junior doctors went on strike as the British Government have been trying to impose changes with no increase in funding. We may well see similar attacks on our public health system as those happening to the NHS in the UK. We have a similar situation in which health funding has been declining as a proportion of GDP. This is all related to the general crisis in capitalism.

5. You’re involved in the Health Sector Workers Network of Aotearoa / New Zealand. How did this network come together and what work do you do?

HSWN is a solidarity network setup to connect workers throughout the health sector. Our aim is to bring different workers together to organise and act on issues. In Aotearoa/New Zealand, there are a number of Unions which support workers along trade/profession lines. This means often doctors are separate, social workers are in a group and Nurses are their own union. There is a lot of division in our sector, we are trying to see if we can overcome this.
So far we have:
-organised solidarity rallies for the striking Junior Doctors, joining their protest/pickets when they have twice been on strike.
-organised street collections for Ambos from FIRST Union and from doing so been effective in helping them win a backdown from St John on the 10% wage deduction for taking low level industrial action.
-participated as first aiders at a blockade of a weapons conference in Auckland.
-participated in direct actions to prevent the eviction of a tenant from a state house.
-put out a number of solidarity statements in support of other health sector workers direct actions i.e. Junior Doctors and Ambos.
-organised an education evening in Auckland.

6. What are the political goals of the project?
As we have only been in existence for just over one year, these goals have yet to be fleshed out. At this stage network members would all be in agreement that we are trying to build solidarity amongst all workers in the health sector and that our intention is to bring together the most radical health sector workers.

We are also aiming at building links with indigenous and minority groups. We are part of an ecosystem of organisations and movements. Ultimately, building connections with a wide range of groups is part of this project to build a voice and create action towards a more holistic, person centred health sector.

Where we go from here will depend on our activities but as things heat up in the health sector due to massive cuts/underfunding we will hopefully see more direct action that will attract new members.

7. What is the state of the health system in New Zealand and what are the main tasks for a health workers movement in the coming years?

There has been a massive amount of underfunding for the last 6 years, which is making it hard for workers in the health sector. Some figures put this at $1.85 Billion over this time. This is on the back of progressive neo-liberal changes to the health system since the late 1980s (i.e. increase in private providers and NGO, reduction in union membership, diversification and professionalization of workers, etc).

There is significant unmet need and inequalities across New Zealand. This has been growing year after year. The health system is trying to cope with this, but can only do so much.

We imagine the health worker movement needs to realise their potential strength, unite under a collective banner and push for change. The immediate focus concerns funding, but additional struggle around bringing back stable public funded providers, improve availability of union benefits (i.e. bargaining power) and challenge neoliberal capitalist agendas in the health system.

As well as opposing capitalism more generally, one of our goal we have discussed is to articulate a positive vision of a post-capitalist health system. What would it look like? How would it work? This is something that we and all health sector workers need to reflect on and push for in the future. It’s not enough to be critical and resist, we need to build and have vision.

8. Do you see parallels with the issues of health care and health workers in other countries?

The effects of austerity measures are pretty much everywhere. Health systems/services globally are in crisis. As the effects of capitalist economics continue to expand the inequalities inherent in class society we need to start articulating a post-capitalist vision for the health system. We need to build power from below and develop new ways of resistance.

9. Do you have any suggestions for how we can build a truly international movement for health workers and health?

The idea of solidarity should not be a radical concept. There is much that unites us and we need to articulate this through extending solidarity internationally and building links to health sector struggles everywhere. Maybe down the road we may see international federations of radical health sector workers formed and with the rise of far right politics globally, together with resurgence of nationalism, all of our collective efforts to organise are becoming more crucial.